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1.
Medicine (Baltimore) ; 99(40): e21433, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33019381

RESUMO

INTRODUCTION: Intradural schwannomas can occur at any level of the spine. According to the literature, approximately 8% of intradural schwannomas occur in the atlantoaxial spine, and these tumors are usually located in the posterolateral or lateral spinal cord. In contrast, tumors in the ventral midline of the spinal cord are relatively rare. PATIENT CONCERNS: A 47-year-old female presented with progressively worsening neck pain and paresthesias in both upper and lower limbs for the past 5 years. DIAGNOSIS: Based on Magnetic Resonance Imaging and histopathological findings, she was diagnosed with ventral midline primary schwannoma of the cervical spinal cord. INTERVENTIONS: The patient was treated with surgical resection. OUTCOMES: Follow-up visit at 2 years after the surgery showed that the patient is neurologically intact and free of disease. CONLUSION: In summary, for the tumors in the ventral midline of the atlantoaxial spinal cord, the preferred treatment is complete surgical resection by the posterior approach compared to the anterior approach, which often improves clinical symptoms or achieves a healing effect.


Assuntos
Neurilemoma/patologia , Neoplasias da Medula Espinal/patologia , Medula Cervical/diagnóstico por imagem , Medula Cervical/patologia , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Cervicalgia/etiologia , Neurilemoma/diagnóstico , Neurilemoma/cirurgia , Neoplasias da Medula Espinal/diagnóstico por imagem , Neoplasias da Medula Espinal/cirurgia
2.
Praxis (Bern 1994) ; 109(13): 1033-1034, 2020.
Artigo em Alemão | MEDLINE | ID: mdl-33050808

RESUMO

CME Answers: Crowned Dens Syndrome - the Chameleon of Neck Pain Abstract. Crowned Dens Syndrome (CDS) is a rare, under-diagnosed differential diagnosis of acute neck pain. Diagnosis is a challenge in clinical practice due to the similarity of symptoms to other diseases. Knowing this differential diagnosis of acute neck pain, unnecessary examinations and expensive therapy attempts can be avoided with a targeted approach. With this article we would like to sensitize colleagues accordingly.


Assuntos
Cervicalgia , Tomografia Computadorizada por Raios X , Diagnóstico Diferencial , Humanos , Pescoço , Cervicalgia/diagnóstico por imagem , Cervicalgia/etiologia , Síndrome
3.
Praxis (Bern 1994) ; 109(12): 939-943, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32933384

RESUMO

CME: Crowned-Dens-Syndrome - the Chameleon of Neck Pain Abstract. Crowned Dens Syndrome (CDS) is a rare, under-diagnosed differential diagnosis of acute neck pain. Diagnosis is a challenge in clinical practice due to the similarity of symptoms to other diseases. Knowing this differential diagnosis of acute neck pain, unnecessary examinations and expensive therapy attempts can be avoided with a targeted approach. With this article we would like to sensitize colleagues accordingly.


Assuntos
Condrocalcinose , Cervicalgia , Processo Odontoide , Diagnóstico Diferencial , Humanos , Cervicalgia/etiologia , Síndrome
4.
Bone Joint J ; 102-B(8): 981-996, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32731832

RESUMO

AIMS: Whether to perform hybrid surgery (HS) in contrast to anterior cervical discectomy and fusion (ACDF) when treating patients with multilevel cervical disc degeneration remains a controversial subject. To resolve this we have undertaken a meta-analysis comparing the outcomes from HS with ACDF in this condition. METHODS: Seven databases were searched for studies of HS and ACDF from inception of the study to 1 September 2019. Both random-effects and fixed-effects models were used to evaluate the overall effect of the C2-C7 range of motion (ROM), ROM of superior/inferior adjacent levels, adjacent segment degeneration (ASD), heterotopic ossification (HO), complications, neck disability index (NDI) score, visual analogue scale (VAS) score, Japanese Orthopaedic Association (JOA) score, Odom's criteria, blood loss, and operating and hospitalization time. To obtain more credible results contour-enhanced funnel plots, Egger's and Begg's tests, meta-regression, and sensitivity analyses were performed. RESULTS: In total, 17 studies involving 861 patients were included in the analysis. HS was found to be superior to ACDF in maintaining C2-C7 ROM and ROM of superior/inferior adjacent levels, but HS did not reduce the incidence of associated level ASD. Also, HS did not cause a higher rate of HO than ACDF. The frequency of complications was similar between the two techniques. HS failed to achieve more favourable outcomes than ACDF using the NDI, VAS, JOA, and Odom's scores. HS did not show any more advantages in operating or hospitalization time but did show reduction in blood loss. CONCLUSION: Although HS maintained cervical kinetics, it failed to reduce the incidence of ASD. This finding differs from previous reports. Moreover, patients did not show more benefits from HS with respect to symptom improvement, prevention of complications, and clinical outcomes. Cite this article: Bone Joint J 2020;102-B(8):981-996.


Assuntos
Vértebras Cervicais/cirurgia , Discotomia/métodos , Degeneração do Disco Intervertebral/cirurgia , Amplitude de Movimento Articular/fisiologia , Fusão Vertebral/métodos , Substituição Total de Disco/métodos , Adulto , Idoso , Bases de Dados Factuais , Avaliação da Deficiência , Feminino , Humanos , Degeneração do Disco Intervertebral/diagnóstico por imagem , Japão , Masculino , Pessoa de Meia-Idade , Cervicalgia/etiologia , Cervicalgia/fisiopatologia , Cervicalgia/cirurgia , Medição da Dor , Prognóstico , Estudos Retrospectivos , Índice de Gravidade de Doença , Espondilose/diagnóstico por imagem , Espondilose/cirurgia , Resultado do Tratamento
7.
Saudi Med J ; 41(6): 652-656, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32518934

RESUMO

Immunoglobulin G4-related disease (IgG4-RD) is rare disease entity and has recently been recognized as an inflammatory disorder with the tendency to affect multiple organs. Pachymeningitis of spine caused by IgG4-related disease is extremely rare. Neck pain and spinal cord compression symptoms consist of usual presentation of IgG4-related spinal pachymeningitis; however, polyarthritis is an unusual presentation of this disease, and it was reported in only one case that mimicked psoriatic arthritis. In this report, we describe a case of IgG4-related spinal pachymeningitis in a middle-age male who presented initially with neck pain and  rheumatoid arthritis-like symptoms and later on developed both right upper and lower limb weakness. He was found to had pachymeningeal thickening on a cervical magnetic resonance image (MRI) and elevated serum IgG4 levels. He was treated with glucocorticoids and rituximab, which led to a significantly positive radiological response.


Assuntos
Doença Relacionada a Imunoglobulina G4/complicações , Meningite/etiologia , Adulto , Artrite Reumatoide/etiologia , Biomarcadores/sangue , Vértebras Cervicais , Extremidades , Glucocorticoides/uso terapêutico , Humanos , Imunoglobulina G/sangue , Imagem por Ressonância Magnética , Masculino , Meningite/diagnóstico , Meningite/tratamento farmacológico , Debilidade Muscular/etiologia , Cervicalgia/etiologia , Rituximab/uso terapêutico , Compressão da Medula Espinal/etiologia , Resultado do Tratamento
9.
Arch Oral Biol ; 114: 104718, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32334135

RESUMO

OBJECTIVES: The present study purposed to observe the response of comorbidities of temporomandibular disorders (TMD) including migraine and cervical dysfunction after painful TMD treatment. DESIGN: A total of 187 patients were included: 45 had no symptoms related to the painful TMD and migraine (Control), 52 had the painful TMD only (pTMD), 47 had the painful TMD that occurred earlier than the migraine (TMD1ST), and 43 had the migraine that occurred earlier than the painful TMD (MIG1ST). All patients were diagnosed based on the Research Diagnostic Criteria for Temporomandibular Disorders and International Classification of Headache Disorders, 3rd edition. Head and neck posture were assessed using lateral cephalogram. Myofascial trigger points were evaluated in the two masticatory and four cervical muscles. Stabilization splint therapy and physical therapy were applied to all patients for six months. RESULTS: MIG1ST showed lesser improvement of the intensity of the orofacial and neck pain and forward head posture than the pTMD and TMD1ST after 6 months TMD treatment. In addition, lesser degree of symptomatic progress of intensity, duration and frequency of the migraine in MIG1ST was detected than in TMD1ST after 6 months TMD treatment. CONCLUSION: The effects of TMD management on symptomatic changes of its comorbidities including the migraine and cervical dysfunction could be determined by onset order of comorbid conditions relative to TMD.


Assuntos
Transtornos de Enxaqueca/terapia , Cervicalgia/terapia , Postura , Transtornos da Articulação Temporomandibular/terapia , Humanos , Transtornos de Enxaqueca/etiologia , Cervicalgia/etiologia , Estudos Retrospectivos , Transtornos da Articulação Temporomandibular/complicações
10.
World Neurosurg ; 139: 136-141, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32283320

RESUMO

BACKGROUND: Granular cell tumors (GCT) are rare soft tissue neoplasms with a nerve sheath origin, most often found in female adult populations. When these tumors arise in the central nervous system, they most commonly appear intradurally in the thoracic or lumbar spine. GCT malignancy rates vary and recurrence rates can be relatively high, thereby necessitating complete resection. CASE DESCRIPTION: We present an exceedingly rare case of an intradural, extramedullary GCT originating in the anterior cervical spine of a male pediatric patient who presented with progressive neck pain and gait instability. CONCLUSIONS: The patient underwent an anterior C7 corpectomy for resection of the tumor, followed by stabilization and fusion, and recovered without neurologic deficit. A literature review of spinal GCTs is provided.


Assuntos
Vértebras Cervicais/cirurgia , Tumor de Células Granulares/cirurgia , Procedimentos Neurocirúrgicos/métodos , Neoplasias da Medula Espinal/cirurgia , Adolescente , Tumor de Células Granulares/complicações , Tumor de Células Granulares/diagnóstico por imagem , Tumor de Células Granulares/patologia , Cefaleia/etiologia , Humanos , Imagem por Ressonância Magnética , Masculino , Cervicalgia/etiologia , Neoplasias da Medula Espinal/complicações , Neoplasias da Medula Espinal/diagnóstico por imagem , Neoplasias da Medula Espinal/patologia , Fusão Vertebral
11.
Am J Otolaryngol ; 41(4): 102497, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32345445

RESUMO

PURPOSE: Whiplash is a type of trauma typically caused by a rear end collision in a road accident. About one in two patients who experience whiplash report dizziness and balance problems, which can severely affect their activities in daily life. In industrialized countries, the number of elderly people with a driving license has increased in recent years. The aims of the present study were to describe the video-nystagmographic features in a consecutive series of elderly patients experiencing whiplash injury in a road accident, comparing them with similar injuries in a group of young adults. METHODS: Twenty-seven patients aged 65 years or more and a control group of 32 young adults between 18 and 21 years old were retrospectively selected. All patients underwent oto-vestibular assessment and video-nystagmography. RESULTS: After whiplash trauma, vertigo was more common in elderly patients with decreased peak velocity during the saccadic ocular motricity test (p = 0.017) and with evidence of bilateral vestibular hypofunction after caloric stimulation (p = 0.033). Comparing the two age groups, neck pain after the trauma was reported significantly more by young adults (p = 0.003), who also showed more frequently bilateral vestibular hypofunction (p = 0.025). CONCLUSION: Clinical and instrumental findings seem to support the hypothesis of a functional lesion to the brainstem regions after a whiplash injury. There is an undeniable need, however, for tools capable of objectively assessing the functional or anatomical damage resulting from whiplash-associated disorders, for both clinical and medico-legal reasons.


Assuntos
Acidentes de Trânsito , Eletronistagmografia , Gravação em Vídeo , Traumatismos em Chicotada/diagnóstico por imagem , Adolescente , Idoso , Feminino , Humanos , Masculino , Cervicalgia/etiologia , Equilíbrio Postural , Traumatismos em Chicotada/complicações , Adulto Jovem
12.
J Am Acad Orthop Surg ; 28(17): 730-736, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32324708

RESUMO

INTRODUCTION: Musculoskeletal injury can substantially affect orthopaedic surgeons and productivity. The objective of this study was to assess occupation-related neck pain and cervical radiculopathy/myelopathy among orthopaedic surgeons and to identify the potential risk factors for injury. METHODS: An online survey was sent to orthopaedic surgeons via their state orthopaedic society. The survey consisted of items related to orthopaedic practices, such as the number of arthroscopic procedures done and the use of microscopes/loupes. The prevalence, potential causes, and reporting practices of neck pain and cervical radiculopathy/myelopathy among orthopaedic surgeons were also assessed. RESULTS: There were 685 responses from surgeons representing 27 states. A total of 59.3% of respondents reported neck pain and 22.8% reported cervical radiculopathy. After adjusting for age and sex, surgeons performing arthroscopy had an odds ratio of 3.3 (95% confidence interval: 1.4 to 8.3, P = 0.007) for neck pain. Only five of the surgeons with neck pain and one of the surgeons with cervical radiculopathy/myelopathy had ergonomic evaluations. CONCLUSION: Neck pain and cervical radiculopathy/myelopathy are common among orthopaedic surgeons. Associated factors included older age, higher stress levels, and performing arthroscopy. Cervical injuries are rarely reported, and ergonomic workplace evaluations are infrequent.


Assuntos
Cervicalgia/epidemiologia , Doenças Profissionais/epidemiologia , Cirurgiões Ortopédicos/estatística & dados numéricos , Radiculopatia/epidemiologia , Doenças da Medula Espinal/epidemiologia , Adulto , Fatores Etários , Artroscopia/efeitos adversos , Artroscopia/estatística & dados numéricos , Vértebras Cervicais , Ergonomia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cervicalgia/etiologia , Doenças Profissionais/etiologia , Radiculopatia/etiologia , Fatores de Risco , Doenças da Medula Espinal/etiologia , Inquéritos e Questionários , Local de Trabalho
14.
World Neurosurg ; 138: 115-119, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32147560

RESUMO

BACKGROUND: Nonlethal neural tube defects are developmental malformations with complex pathogenesis usually manifested at birth or in childhood. CASE DESCRIPTION: We report the case of a 61-year-old woman without significant previous clinical history presenting for neck pain and stiffness. An extensive workup detected multiple lytic lesions within the occipital bone and cervical vertebrae, suspicious for multiple myeloma or metastatic disease. Surgical resection of the occipital bone lesions revealed ectopic cerebellar tissue, some containing folia with mature cortical lamination, and no evidence of malignancy. CONCLUSIONS: To our knowledge, this study describes the oldest individual presenting with ectopic cerebellar tissue and the only instance in which oncologic workup for malignancy was carried out prior to resection. It also proposes surgical resection as a diagnostic and curative approach for this complex basicranium and neural developmental defect, and discusses retinoic acid toxicity as a possible cause of its occurrence.


Assuntos
Cerebelo/patologia , Coristoma/patologia , Osso Occipital/patologia , Neoplasias Cranianas/patologia , Neoplasias Cerebelares/patologia , Neoplasias Cerebelares/cirurgia , Cerebelo/cirurgia , Coristoma/diagnóstico , Coristoma/cirurgia , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Cervicalgia/etiologia , Procedimentos Neurocirúrgicos/métodos , Osso Occipital/cirurgia , Neoplasias Cranianas/diagnóstico , Neoplasias Cranianas/cirurgia
15.
J Clin Neurosci ; 75: 225-228, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32178992

RESUMO

Atlantoaxial rotatory fixation (AARF) in an adult without any trauma is an extremely rare condition. Here we report a case of surgical treatment for existing atlantoaxial rotatory fixation in an adult with spastic torticollis. A 50-year-old man had become aware of torticollis without any cause of injury 6 weeks before he visited our hospital, where he presented with a one-week history of severe neck pain. Based on the local and imaging findings, we diagnosed him as having existing AARF of Fielding classification type I. The AARF was not reduced by 3 weeks of Glisson traction. Thus, we performed C1-C2 posterior fusion surgery 3 months after his initial visit. Although CT findings just after surgery showed that the C1-2 facet subluxation was reduced, the complaint of torticollis was not improved, with scoliosis at the middle to lower cervical level because of left sternocleidomastoid hypertonia. Administration of diazepam was initiated 2 weeks after surgery and botulinum toxin injections to the left sternocleidomastoid were added 2 months after surgery under the neurological diagnosis of spastic torticollis. As a result, the complaint of his torticollis was significantly improved 3 months after surgery. There were no relapses of the torticollis and complete fusion of the C1-C2 laminae was observed at the 2-year final follow-up. Surgical treatment for AARF in an adult should be considered if the diagnosis of AARF is delayed. In addition, appropriate treatment for spastic torticollis applied after surgery resulted in a favorable outcome of this case.


Assuntos
Articulação Atlantoaxial/diagnóstico por imagem , Espasticidade Muscular/diagnóstico por imagem , Espasticidade Muscular/terapia , Fusão Vertebral/métodos , Torcicolo/diagnóstico por imagem , Torcicolo/terapia , Articulação Atlantoaxial/cirurgia , Toxinas Botulínicas Tipo A/administração & dosagem , Diazepam/administração & dosagem , Humanos , Luxações Articulares/complicações , Luxações Articulares/diagnóstico por imagem , Luxações Articulares/terapia , Masculino , Pessoa de Meia-Idade , Relaxantes Musculares Centrais/administração & dosagem , Espasticidade Muscular/complicações , Cervicalgia/diagnóstico por imagem , Cervicalgia/etiologia , Cervicalgia/terapia , Torcicolo/complicações
16.
Agri ; 32(1): 55-57, 2020 Jan.
Artigo em Turco | MEDLINE | ID: mdl-32030703

RESUMO

Cervical artery dissection is an acute arterial disease. Although it is not a common disease, 40-60% cerebral infarction and 20-30% transient ischemic attack could be seen. Thus, cervical artery dissection is important to recognize. Fifty-three years old female patient consulted with head, neck and face endaural pain that started after than spread directly left face half, effect of sometimes orbita and sometimes submaxillary area, occasionally accompanied by redness in the eye, extending from a few minutes to a few hours, it has been sharp and pulsatil characteristics and she never experienced before similar. Although not typical, with the initial diagnosis was trigeminal neuralgia and cluster headache (CH), carbamazepine and tramadol treatment were started. The patient who had neck pain was severe during USG, and with atypical features was BT angioed to the brain and neck concerning differential diagnosis of the patient. It was detected profile compatible with dissection at left ICA proximal. In the literature, there are rare cases of ICA dissection mimicking CH and other trigeminal autonomic cephalalgias. A common recommendation in CH case reports is the need for neurovascular imaging in cases with atypical features.


Assuntos
Dissecação da Artéria Carótida Interna/diagnóstico , Dissecação da Artéria Carótida Interna/complicações , Dissecação da Artéria Carótida Interna/diagnóstico por imagem , Cefaleia Histamínica , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cervicalgia/etiologia , Neuralgia do Trigêmeo
18.
J Orthop Sports Phys Ther ; 50(1): 33-43, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31892290

RESUMO

OBJECTIVE: Cervical sensorimotor outcomes have been suggested to be important in the assessment of individuals with neck pain. However, the large variety of sensorimotor control tests used in varying populations makes it difficult to draw conclusions about their clinical value. We aimed to compare cervical sensorimotor control outcomes between individuals with chronic idiopathic neck pain and asymptomatic individuals using a battery of recommended tests, and to investigate the correlation between cervical sensorimotor control outcomes and pain intensity and neck disability. DESIGN: Case-control study. METHODS: Fifty participants with chronic idiopathic neck pain and 50 age- and sex-matched asymptomatic controls completed 7 cervical sensorimotor control tests: joint position error (including joint position error torsion), postural balance, subjective visual vertical, head-tilt response, "the Fly," smooth pursuit neck torsion, and head steadiness. Between-group differences were investigated with the Mann-Whitney U test. Correlations between tests and levels of neck pain and disability were investigated using the Spearman rho. RESULTS: There were no differences in cervical sensorimotor outcomes between participants with chronic idiopathic neck pain and asymptomatic controls for any test (P = .203-.981). For each test, "poor performers" consisted of both individuals with and without neck pain. Correlations were weak between tests and levels of neck pain (r = 0.010-0.294) and neck disability (r = 0.007-0.316). CONCLUSION: These findings suggest that sensorimotor control disturbances in individuals with chronic idiopathic neck pain may not be present, spawning debate on the clinical usefulness of these tests. J Orthop Sports Phys Ther 2020;50(1):33-43. Epub 23 Aug 2019. doi:10.2519/jospt.2020.8846.


Assuntos
Dor Crônica/diagnóstico , Cervicalgia/diagnóstico , Exame Neurológico , Adulto , Estudos de Casos e Controles , Dor Crônica/etiologia , Dor Crônica/fisiopatologia , Estudos Transversais , Feminino , Cabeça/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Cervicalgia/etiologia , Cervicalgia/fisiopatologia , Equilíbrio Postural/fisiologia , Propriocepção/fisiologia
20.
J Neurol Surg A Cent Eur Neurosurg ; 81(3): 264-270, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31962352

RESUMO

We describe a case of an intradural extramedullary inflammatory myofibroblastic tumor of the cervical spine. A 56-year-old woman presented with progressive neck pain, radiating to the right scapula, without any neurologic deficit. Magnetic resonance imaging showed an intradural extramedullary tumor with a dural tail sign, located at the C3-T1 segment with homogeneous contrast enhancement. The patient was operated on for a suspected meningioma. Pathologic examination showed fibrosis and inflammation with infiltration of B and T lymphocytes accompanied by plasmocytes, macrophages, and myofibroblast oocytes. We present the clinical course and review of the literature.


Assuntos
Vértebras Cervicais , Granuloma de Células Plasmáticas/diagnóstico , Granuloma de Células Plasmáticas/cirurgia , Doenças da Medula Espinal/diagnóstico , Doenças da Medula Espinal/cirurgia , Diagnóstico Diferencial , Feminino , Humanos , Imagem por Ressonância Magnética , Neoplasias Meníngeas/patologia , Meningioma/patologia , Pessoa de Meia-Idade , Cervicalgia/etiologia , Canal Vertebral
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